Willingness to Pay for Health Insurance among Attendees of Selected Urban Health Centres in Myanmar

Abstract

Background: Reforming health system in Myanmar is crucial aiming to achieve universal health coverage in 2030. High out-of-pocket (OOP) payment is the main cause of increasing financial hardship, and hence, implementing effective health insurance system is necessary to lower the financial burden. Since it is novel for most people, it is mandatory to consider their willingness upon such system. 

Objective: This study aimed to assess the willingness to pay (WTP) status for proposed health insurance plan among the attendees visiting selected urban health centers (UHCs) of Myanmar.

Methods: The cross-section study was conducted on 261 out-patient department (OPD) attendees visiting selected UHCs in Yangon Region, Myanmar from July-December, 2023. Two UHCs were selected using simple random sampling from a purposively selected district, and the participants were recruited consecutively. Face-to-face interview was done using questionnaires and contingent valuation method (bidding approach). Binary logistic regression was done to determine factors influencing the WTP status.

Results: The results showed that awareness of the health insurance was low (37.5%). Among all, 61.1% of the participants were willing to pay for the recommended amount [10,000MMK per month per person (~5US$)] and higher for proposed plan. The WTP was negatively associated with older age group (AOR: 0.35, CI: 0.12-0.97), poor self-rated health status (AOR: 0.32, CI: 0.11-0.95), and not experiencing illness within one year (AOR: 0.46, CI: 0.22-0.94), but positively associated with higher average monthly family income (AOR: 2.07, CI: 1.10-3.88).

Conclusion: The finding indicates that the WTP level of participants for health insurance was relatively high once it was established. The result also provides amount for monthly premium.  Therefore, policy makers should consider building up robust health insurance system with comprehensive coverage, and using the premium as one of the reference values for upcoming health insurance plan.